Individual
BETH LAURIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
11850 BLACKFOOT ST NW STE 130, COON RAPIDS, MN 55433-2583
(763) 236-6061
(763) 236-6065
Mailing address
11850 BLACKFOOT ST NW STE 130, COON RAPIDS, MN 55433-2583
(763) 236-6061
(763) 236-6065
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19834
MN
Other
Enumeration date
09/11/2019
Last updated
11/18/2020
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